Author’s note: It is with deep respect that I approach the topic of Chrissy Teigen’s 2020 pregnancy loss. In fact, despite disagreeing with Teigen’s misuse of the term “abortion,” I would argue that we can learn much from her approach to such tragedy, especially the need for gratitude. As she wrote in response to the huge outpouring of love and support she received, “the worst part is knowing there are so many women that won’t get these quiet moments of joy from strangers. I beg you to please share your stories and to please be kind to those pouring their hearts out. Be kind in general, as some won’t pour them out at all.” It is for these women – and these often hidden conversations – that I wrote this article.
Caring for a Woman with a Placental Abruption
On September 15, 2022, Chrissy Teigen admitted to having had a “life-saving abortion” back in 2020. Up until this recent statement, she had only referred to her child’s death as a miscarriage. In a beautifully poignant letter penned by her in October of 2020, she explains that her pregnancy loss was the result of a placental abruption, a medical condition whereby the placenta detaches from the uterine wall. (The placenta grows during pregnancy and exchanges nutrients and waste between mom and baby. The baby, which grows in a healthy, fluid-filled sac called the amniotic sac, is attached to the placenta via the umbilical cord.)
From an obstetrics standpoint, in the situation of a severe placental abruption like Teigen’s, the mother will continue to bleed excessively, negating the helpfulness of blood transfusions because she cannot stop losing blood. Simply put, the woman cannot survive unless the placenta – including the baby inside – is removed, and so delivery must be induced (usually with the use of Pitocin, a drug which opens up the cervix and helps initiate contractions). Before the 22nd or 23rd week of pregnancy, the baby is not yet viable outside of the womb; but after 23 weeks, there is a chance for survival.
None of this, however, changes the gravity of the circumstances for the other patient: the mother. A mother must be delivered of her baby during a severe placental abruption, or she will lose her life. And so enters the question at hand: Did Teigen actually have an abortion?
Is “Abortion” an Accurate Term for Teigen’s Life-Saving Treatment?
As a female bioethicist specializing in issues related to women’s health, I have learned that in medical situations, when you’ve seen one case, you’ve seen one case. In other words, it is hard to make objective judgments for every aspect of Teigen’s case without having her medical records, nor is that my privileged position to hold. Still, this does not prevent me from stating that her claiming to have had an abortion only intensifies the recent concern of many women: fear of being unable to receive life-saving treatments if needed because of the current illegality of abortion.
In her recent statements, Teigen shared that her husband, John Legend, had brought to her attention that she had had an abortion, and she effectively stated that she no longer wanted to mince her words: “Let's just call it what it was. It was an abortion. An abortion to save my life for a baby that had absolutely no chance.” Here, her use of the word “abortion” only further confuses the issue. She was absolutely right that her baby had no chance, but what has been frustrating for many, including physicians, is this blatant disinformation. While a miscarriage is medically referred to as a “spontaneous abortion,” a miscarriage and the kind of abortions referred to by Roe v. Wade are not the same thing. Teigen is right to admit that she did not have a miscarriage – and the fact remains that she did not have an abortion, either.
Spreading Disinformation About Abortion Harms Women Further
In order to frame this more clearly, I interviewed Dr. Angela Parise, an OB/GYN in New Orleans who has practiced medicine for over 23 years. Parise shared with me the frustration that she has experienced over these last few months as a result of disinformation and argued that referring incorrectly to the care Teigen received as a “life-saving abortion” creates an unnecessary panic for so many women and the men who love them. According to Parise, the media and lack of knowledge is harmful: “It’s the way they twist the picture, and it makes me very upset. It’s an issue for me that they’re not making this distinction because nothing in my practice of medicine for 23+ years – the way I treat a mom who has lost her baby or how I must intervene for pregnancy complications – has changed. You cannot tell me that this law has changed the way I save a mom’s life. That’s not correct.”
As we spoke, Dr. Parise made it clear that she has been trained to treat two patients when she cares for a pregnant woman: mom and baby. When a woman comes in with an abruption, whether at 16 weeks or 38 weeks, “delivery of the baby is the mode.” In other words, the key term here is “delivery,” not “abortion”; the intent is the care of the mother, not the intentional killing of the child. “The new law does not change my ability to perform D & Cs and deal with miscarriages. When a woman is pregnant and an embryo dies [as in a miscarriage within the first trimester], you [the physician] clear out the uterus,” Parise said. An abortion, however, is different; it is the act of “taking a healthy pregnancy and taking it away” when there is no medical need to do so. Such actions are completely unlike those taken during a placental abruption.
“Where it gets tricky [in these circumstances of placental abruption] is the second trimester. If you have a 16-week live baby, beautifully healthy and gorgeous, and mom has a severe situation where she’s bleeding, like a placental abruption… that baby has to be delivered. This forced delivery to save the mother’s life is going to result in fetal death. But that is not the same as an abortion.” As Dr. Parise confirmed in response to Teigen’s case, it was best – medically necessary, even – to deliver Teigen of the child and to save the mother’s life. This action, however, was not a direct abortion: “[Teigen] had time to get an epidural, time to get Pitocin. There was no reason to kill that baby, but its death was the result of the medically necessary care. The result was the baby didn’t make it; not the other way around, that ‘I killed this baby.’”
The Difference Between Life-Saving Treatment and an Actual Abortion
In my own work as an educator and speaker on bioethics, I have realized that many people do not realize that, from a Catholic perspective, this kind of treatment is completely justified. While the Catholic Church is clear that the ends of an action never justify the means, this does not negate an essential principle within her ethical framework: double effect.
The double effect principle comes into play whenever there are two equally important goods, or subjects of great value, to consider in a given action. In this case of placental abruption, the equally important goods are the life of the mom and the life of the baby. The baby cannot survive in these situations without the mother and, regardless of how far along she is, the mother cannot survive if it is severe (as in the case of Teigen). In these cases, any good physician wants to save both lives. As nature has it, however, the mother will lose her life unless she is delivered of her child, and the baby will lose his life if his mother doesn’t survive.
This principle is what Dr. Parise realizes innately as a physician who has been faced with these difficult decisions at various points throughout her career: “If mom is truly 23 weeks and comes in with an abruption, I will do what I do at 41 weeks, 42 weeks. I do the same thing. I save mom; I get out baby. The baby may have died, but we fight for life, not death.”
These issues are difficult because they pull upon things deep inside of us as human beings, and especially as women. Instead of perpetuating confusion by equating life-saving treatment (inducing the early delivery of a baby) with the medical act of direct abortion (the intentional ending of a baby’s life despite no truly life-threatening situations for the mother or the baby), we should educate and empower women so that they realize the difference between life-saving treatment and an actual abortion. All OB/GYNs are trained to recognize this difference and, in these situations, they not only can but must take it into account.
Reassuring Women That They Will Receive the Care They Deserve
In the end, Dr. Parise wanted to highlight the need for truth. In a tone of intellectual honesty and humility, she made clear her professional opinion:
“My care has not changed. I have no fear about doing the exact same care I’ve done for 23 years. This is something I have done since I was a medical student. There has been no deviation [since June]. I value mothers. I value life. I value caring for a mom who is facing a very difficult decision. But when it comes down to it, we’re gonna take care of mom and baby. It’s very disheartening and concerning to me because now patients have so much fear. And they have fear that physicians are not going to offer appropriate medical care when necessary. …In the end, all OB/GYNs have been trained to care for mom and baby, to be able to handle life-threatening situations for mom and baby. This law has not changed giving good quality medical care. My practice has not changed because of the overturning of Roe v. Wade. And we’re not hearing that. We’re hearing everything else.”
Words have power. When it comes to the unexpected loss of a baby, no words can alleviate a woman’s pain. So instead of robbing women of the heartache of losing their child in a completely unintentional way by misappropriating words and referring to these situations as abortions, let’s respect the true meanings of these terms. Let’s make clear the distinction, especially in light of what the Church actually teaches.
The Church’s primary commandment is a commandment of love, and sometimes this love demands that a doctor help a mother deliver her child – a child who cannot survive without her – in order to preserve her life. The value of woman’s life is great. The value of baby’s life is great. The value of good medical care is essential. And as made clear by Dr. Parise, women have every reason to believe that they will indeed receive the care they deserve and in a way that respects the objective circumstances of their baby’s life and the hard decision of sometimes having to let go too soon.